The Healthcare Educational and Research Foundation (HERF) in Minneapolis undertook a two-year research project to study the effects of health maintenance organizations (HMOs) and competition on the hospital industry in Minneapolis/St. Paul. This article summarizes HERF's major findings surrounding three key questions: (1) do the HMOs in Minneapolis/St. Paul use fewer hospital resources relative to conventional payers?; (2) do recent overall community trends in inpatient use suggest evidence of hospital utilization-reducing effects attributable to HMOs?; and (3) given the highly visible competitive process among Minneapolis/St. Paul providers, do hospital cost and revenue data suggest any evidence of cost-containment? The findings (based on data through 1982) indicate that for comparable patients, Twin Cities HMOs appear to use fewer medical care resources per hospitalized patient. There was, however, no clear evidence of community-wide, utilization-reducing effects directly attributable to the "competitive effect" of HMO introduction and development in the market. In addition, there was no empirical evidence that HMOs (which had enrolled 25 percent of the consumer market by 1982), or other large buyers of inpatient services, have selected hospitals on the basis of price as hypothesized by competition advocates. 相似文献
Adolescent incest sexual perpetrators seen at an out-patient clinic were interviewed regarding demographic characteristics and occurrence of deviant and nondeviant sexual behaviors. Results indicate that subjects (1) committed more sexual crimes than they had been arrested for, (2) reported a very early onset of sexual behavior, (3) had additional DSM-III psychiatric disorders, and (4) reported previous sexual victimization. Recommendations for future research are made. 相似文献
A large number of corpses transferred to Athens and the Piraeus Morgue from abroad have been examined in second autopsies. Lack of information, mistakes in data, useless effort, and disappointment on the part of the forensic pathologists because of the lack of new information revealed are characteristic of these cases. With some exceptions, the second autopsy provided no news for the anxious relatives, who, for the most part, had been prompted by their attorneys or other "well-meaning friends" to demand a second autopsy on the corpses of their loved one (who generally died on board ship abroad). Nevertheless, in 10 of 59 cases, the cause of death was completely different from the determined in the autopsy performed abroad or assumed from the information available. This fact ensures that any corpse from abroad undergoes a careful and thorough examination on its arrival in Greece. 相似文献
Upon coming to office, President Ronald Reagan proposed a numberof programs collectively referred to as the New Federalism.These programs were designed to alleviate some of the problemswhich the president saw as plaguing the intergovernmental systemand to accomplish Reagan's goal of decentralizing authority.One of the most highly publicized and debated indeed,probably the most controversialaspect of the President'sNew Federalism package was the "Big Swap" plan. Both versionsof this plan, however, were bad deals for the states and theircommunities, and it would appear that several interrelated economicconcerns played a role in the opposition of many state and localofficials to these proposals. To demonstrate just how bad theseproposals were, the article documents the effect that inflationand recession had had on the fiscal health of state and localgovernments, and the projected impact that these plans wouldhave had on state and local revenue and tax systems. 相似文献
Handbook of Legal Information Retrieval Edited by J Bing, Norwegian Research Centre for Computers and Law, Oslo, in co‐operation with T Fjeldvig, T Harvold and R Svoboda North‐Holland 1984, US $96.25
Information Technology: The Challenge to Copyright. James Lahore, Gerald Dworkin and Yvonne Smyth Sweet & Maxwell and The Centre for Commercial Law Studies 1984, £12.00
Data Processing and the Law Edited by Colin Campbell Sweet and Maxwell 1984, £20.00
Le droit des Contrats Informatiques — Principes — Applications Centre de Recherches informatique et droit des Facultes Universitaires de Namur Maison Ferdinand Larder (Brussels), 1983, 45 FB
Computer Insecurity Adrian R.D. Norman Chapman and Hall 1983, £14.95
The Data Protection Act Richard Sizer and Philip Newman Gower Publishing, 1984, £16.95
The Data Protection Act 1984 Professor Bryan Niblett Oyez Longman Publishing, 1984, £18.00
The Data Protection Act 1984 — A Guide to the New Legislation J. A. L. Sterling CCH Editions, 1984, £15.00
Privacy and Data Protection — An International Bibliography Professor David H. Flaherty Mansell Publishing, 1984, £23.50
Computer Contracts R Morgan & G Stedman Oyez Longman Publishing 1984, 2nd Edition, £27.50
In April 1986, one-month-old Lance Tyler Steinhaus sustained serious injuries, attributed to abuse by his father, that left him comatose. His mother and his physicians agreed that he should not be treated aggressively. The Redwood County (Minnesota) Welfare Department obtained a temporary order restraining withdrawal of Lance's antibiotic therapy. Lance's mother and Dr. David Steinhorn, a pediatrician, appealed to the County Court to dissolve the temporary injunction. Judge George I. Harrelson in this decision denied their request on the grounds that both state and federal law establish that infants with life-threatening conditions have a right to medically-indicated treatment and that Lance Steinhaus had such a right because he was in a "vegetative state" rather than technically "comatose." [Editor's note: After conducting another hearing on Lance's neurological status, the court ruled on 18 October that Lance was irreversibly comatose and ordered only "comfort care."] 相似文献
In 1982, Section 2 of the U.S. Voting Rights Act was amendedto allow plaintiffs to prevail in voting rights litigation ifthey demonstrate that a challenged law or practice has a discriminatoryresult. One of the first applications of this new statutoryprovision invalidated a congressional districting plan for theNew Orleans metropolitan area, a plan that had divided the city'sblack population virtually in half. This article reviews boththe making and the unmaking of that plan, derisively known asthe "gerryduck." Although the judicial action invalidating thisexercise in racial cartography demonstrates the potential importanceof this new section of the VRA as a legal weapon against minorityvote dilution, the results test provides federal judges withenormous discretion, and the application of the test may thereforebe quite capricious. 相似文献
This paper highlights the difficulties and complexities of development assistance projects through an analysis of 2 Urban Functions in Rural Development projects conducted by the US Agency for International Development (AID) in Upper Volta and northern Cameroon in 1977-82. The general objectives of the Upper Volta project were to carry out urban function studies, develop a plan for strengthening the contributions of urban centers to rural development, develop a list of investment priorities for facilities and services, and increase the capacities of the Ministry in planning processes and methods. The 2-year project was hindered by a 1-year delay in initiating assistance due to difficulties in locating a contractor. In addition, the contractor and other team members felt there was little justification for studies of spatial organization in a country with so much evident need; rather, they focused on a small rural works program and establishment of effective local government, producing an inconsistency between team activities and the original project agreement. A request by the team to extend the project 1 year beyond its official completion date to compensate for early delays was rejected by USAID. Nonetheless, there was agreement that the project had a small positive impact in Upper Volta. Key lessons from Upper Volta were transferred to the Cameroon project. Although this project was judged to have achieved its objective of preparing a regional plan and of identifying programs for facilities, services, and small-scale enterprises, it was beset by problems of inexperience and technical underqualification of team members, poor communication, inconsistency of USAID guidelines, and methodological confusion. It is suggested that a central challenge for such programs is to create a body of qualified Americans who can work with their local counterparts in meeting the challenges of development. A measure of the success or failure of these projects should be the degree to which learning contributes to improved performance. 相似文献
Much attention has been given of late to the erosion of the "employment-at-will" doctrine. Exceptions to this doctrine began to emerge when courts held that at-will employees could sue if their termination violated public policy. The at-will doctrine was further eroded by court rulings that a contract requiring good cause in order to terminate could be inferred from employee handbooks, company personnel policies, and circumstances of employment. As the initial flood of wrongful termination lawsuits now reaches the appellate level, some guidance on the standards employers must observe can be drawn from court decisions. The authors examine these decisions as well as the legislative reform being proposed in response to them. 相似文献